Biomedical subjects
Publications and source records attributed to T Bauer.
Ogilvie's syndrome is an acute massive dilation of the large bowel without organic obstruction. It can occur from a variety of causes and organ failures. We report on the first patient who has developed this syndrome twice, in both cases after kidney transplantation. The world literature concerning the subject is also reviewed.
We report 2 cases of acute acalculous cholecystitis after radical cystectomy and continent urinary diversion with a Kock reservoir and ileocecal bladder replacement, respectively. Early diagnosis is essential since the mortality is high with conservative treatment. Isotopic cholescintigraphy is an effective diagnostic test and cholecystectomy is the treatment of choice.
Clinical and experimental observations suggest that immune globulin may prevent otitis media (OM) in children. We performed experiments in chinchillas to test the hypothesis that human bacterial polysaccharide immune globulin (BPIG) might prevent OM caused by Streptococcus pneumoniae. Animals were given BPIG or saline intraperitoneally on day 0. On day 3 the epitympanic bulla was inoculated with S. pneumoniae type 7F. All 12 saline-treated and none of 12 BPIG-treated animals developed pneumococcal OM by day 7 (P less than 0.0001). Bacteremia developed in 6 of 12 saline- and 0 of 12 BPIG-treated animals (P = 0.007). Death with pneumococcal OM occurred within 28 days in 5 of 12 saline- and 0 of 12 BPIG-injected animals (P = 0.02). A chinchilla-specific immunoassay was used to show that surviving saline-injected animals developed serum anticapsular antibody; BPIG-treated animals had no detectable response. At levels of anticapsular immunoglobulin G similar to those of human adults, BPIG given systemically prevented pneumococcal OM and disseminated infection in chinchillas. BPIG may be of value in preventing human bacterial infection and may also inhibit development of antibody if it affects local infection or colonization. Specific immunoglobulin G antibody may provide an important antibacterial defense of mucosal surfaces of the respiratory tract.
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In a variety of structural forms, carbon possesses certain properties that render it suitable for implantation in the human body. This report analyzes biocompatibility of a new carbon-carbon prosthesis following long-term middle ear implantation in a prospective, controlled animal study. The prosthesis was placed in the left ear of 20 healthy guinea pigs and in the dorsal subcutaneous tissues for control. The right ear also served as control. Preoperative and postoperative auditory evoked potentials were recorded and compared. Samples of tissue from all three sites were evaluated at 3 and 6 months by light microscopy. The implants also were evaluated by scanning electron microscopy. Samples of lymph nodes, liver, spleen, and lungs also were examined. Fourteen animals (70%) demonstrated no change in auditory evoked potentials postoperatively. One animal developed unilateral dysfunction and three others developed bilateral dysfunction for unexplained reasons. No significant tissue destruction or inflammation of the tissues and no digestion or erosion of the implants were observed. No passage of carbon particles into the reticuloendothelial system was identified. These preliminary results suggest that this new carbon-carbon prosthesis may be biocompatible at 6 months follow-up in the guinea pig and encourage further investigation.
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The third day temperature is frequently used in the decision whether to continue or terminate antibiotic treatment following appendicectomy in perforated appendicitis. To assess the value of the third day temperature in predicting intraperitoneal infectious complications we studied 235 consecutive patients treated with a 3-day course of cefoxitin after surgery for perforated appendicitis. The results demonstrated that regardless of the level of elevated temperature chosen, the predictive value ranged between 16 and 33%. In consequence, elevated third day temperature per se does not provide any rational basis for continuing antibiotic treatment in order to prevent intraperitoneal infectious complications following appendectomy in perforated appendicitis.
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Radically operated tumour patients (gastrointestinal cancer, n = 10; lung cancer, n = 10) were subjected to continuous prospective monitoring of the serum level of tissue polypeptide antigen (TPA) prior to surgical treatment as well as during the subsequent year. The following observations were made: Immediately after radical surgery the serum level of TPA fell temporarily. During the first 2 weeks following this initial decrease, the serum level of TPA rose. In view of the radical surgical treatment the patients had undergone, this finding is interpreted as being not caused directly by the tumour but by tissue repair or proliferation. It is concluded that the first postoperative control of the serum concentration of TPA should be performed not earlier than 4 weeks after tumour resection. If the level of TPA increased after these 4 weeks, the suspicion of a tumour relapse or metastasization was raised. In single cases, a transient rise of serum TPA may not be due directly to the tumour but to other events, e.g. intercurrent infection. In general, the course of the serum level of TPA did not exhibit a marked difference between patients with gastrointestinal and lung cancer.
This study was undertaken to assess the efficacy and safety of a 3-day course of treatment with Mefoxitin (cefoxitin sodium, MSD) in patients with perforated or ruptured appendicitis. A series of 235 patients undergoing surgery for perforated or ruptured appendicitis were treated with cefoxitin for 3 days. Twenty-four patients (10%) developed wound infection and 28 (12%) developed an intra-abdominal abscess postoperatively. No side effects were observed during the study. Compared with the results of our previous series, where a 5-day course of cefoxitin was used, the incidence of wound infection was similar. However the incidence of intra-abdominal abscesses in the present series was significantly higher (p less than 0.01). The results seem to indicate that a 3-day course of cefoxitin is as effective as a 5-day course in controlling the incidence of wound infection following surgery for perforated or ruptured appendicitis, whereas the 3-day course seems to be inferior to a 5-day course in controlling the incidence of intra-abdominal abscesses.
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A double-outlet left ventricle (LV), with a valved conduit interposed between the LV apex and the aorta, was created in 7 dogs with subaortic stenosis. Of 8 dogs in which the implantation was attempted, 1 died following thoracotomy but before conduit implantation could be performed, 1 died from hemorrhage 24 hours after surgery, 1 died from septicemia as a sequel to pneumonia 10 days after surgery, 1 died from "shock-lung" 4 days after surgery, and 4 were functionally normal 22, 12, 6, and 2 months after surgery. In the 7 dogs in which the implantation was completed, the mean LV to aorta (LV-Ao) pressure gradient was significantly (P less than 0.01) reduced by the implantation. Diastolic and systolic murmurs were detected over the prosthetic valve area in 3 of the 4 surviving dogs 1 to 4 days postoperatively, but the murmurs gradually decreased in intensity until they disappeared after 1 month. The 4 survivors had no angiographic evidence of prosthetic valve insufficiency at 2 months or at 1 year. In 3 of the survivors, the LV-Ao pressure gradients 2 months postoperatively were 45, 20, and 0 mm of Hg, as compared with 120, 90, and 50 mm of Hg preoperatively. Postoperative pressure measurements were not obtained on 1 surviving dog.
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